International Journal of Cognitive Therapy. I am grateful for the opportunity to bring together a number of recently completed studies that develop and test new cognitive and behavioral constructs that expand our understanding of factors relevant to the maintenance of obsessive-compulsive O-C cycles and their treatment. Exposure response prevention ERP is the most well-researched and recognized psychotherapeutic intervention for OCD and is consistently included as a frontline treatment in clinical guidelines NICE, Less frequently studied or well established than ERP as a treatment for OCD, the aim of cognitive therapy is to reduce obsessions and compulsions by targeting the maladaptive appraisals and dysfunctional beliefs that are implicated in the development and persistence of symptoms.
The majority of meta-analyses and controlled trials have examined ERP versus cognitive therapy and found them to be equally efficacious treatments on outcome measures at post-treatment and follow-up and recent studies have increasingly tested and shown support for their integration as a combined CBT intervention. The papers included in this Special Issue address different aspects of the O-C cycle within an integrated cognitive-behavioral therapy CBT framework — beliefs and appraisals, safety behaviors, and developments in mindfulness-based approaches that introduce new ways of conceiving of O-C symptom maintenance and change.
In the first article, Riskind et al. In a non-clinical sample, the first study examines the presence of dimensional OCD symptom scores and then examines the cross-sectional associations between standard self-oriented negative appraisals of intrusions and a newly constructed measure that examines the expected negative reactions of others. The results indicated that the anticipated social component contributes to the prediction of OCD symptom scores above and beyond self-oriented negative appraisals. Riskind and colleagues highlight an understudied and important social appraisal component in the O-C cycle.
The second paper by Orr et al. Clinical participants with OCD were compared to non-psychiatric controls in their self-reported tendency to seek reassurance in addition to other symptom measures and a measure of cognitive self-confidence. The results also demonstrate the ERS is associated with lower cognitive confidence, and lower decision-making confidence, specifically.
The results of this study point to the importance of identifying and directly targeting ERS behaviors in the treatment of OCD. The third paper by Katz et al. The results point to the synergy of risk variables in the O-C cycle and how treatment refinements focusing on reducing AS fears may improve treatment outcomes in CBT.
The fourth paper by Cabedo et al. Although the sample size is modest 43 completers , Cabedo et al. These findings show that CBT for OCD can be efficaciously administered in routine clinical practice without sacrificing its efficacy or long-term positive impact. Finally, Selchen et al. The authors provide an overview of the development of the MBCT for OCD treatment protocol and step-by-step procedures that introduce new opportunities to impact on the O-C cycle.
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